Insurance policies are sold on the basis they pay claims for an unanticipated event that results in a loss. This can include claims arising from damage to property and under disability and life insurance policies. When something goes wrong resulting in a claim, the insurance policy sets out the terms of coverage. If covered, the insured is compensated for the loss. While this process can go very smoothly without problems, sometimes insurance companies take the position your claim is not covered and deny coverage for the claim. Not only can that decision can be wrong and unfair, it can result...

Have you made a claim with an insurance company for long-term disability benefits? Has your claim for long-term disability benefits been denied? Have your long-term disability benefits been approved, only to be terminated? Is the struggle slowly killing you? The solution? Settle. It’s good for you. Here’s why. Financial Peace of Mind: A claimant and his or her family frequently face dire financial consequences when the claimant is disabled from working, and then deprived of the disability benefits on which they had expected to rely. A lump sum settlement of a disability claim...

Most of my cases settle, often at mediation. Typically the insurer will bring a “standard” form of release to the mediation for my client to sign. If not, when the insurance company’s lawyer sends me the cheque it will be accompanied by a form of release which my client must sign in order to receive the settlement funds. In either case, the release will always contains something not usually discussed – a confidentiality clause. A confidentiality clause seeks to prohibit the parties to a settlement from disclosing the settlement terms and sometimes more. Confidentiality raises numerous...

When assessing a litigated claim for long-term disability benefits, one very important consideration a disability lawyer must always be aware of is whether the long-term disability benefits are taxable or non-taxable under the specific disability policy at issue in the claim. Long-term disability benefits are typically taxable under a policy when an employer pays a portion (or all) of the insurance premiums on a disability policy. Long-term disability benefits are typically non-taxable under a policy when an employee pays 100% of the insurance premiums on the disability...

The past year has seen many interesting and surprising cases land on my desk. But my most memorable case involved a woman I’ll call April. April had been employed by a financial institution for a number of years when she developed cancer that forced her to stop work in May 2001. She applied for long-term disability benefits under her employer’s group insurance policy. Her claim was approved and benefits were paid starting in November 2001. Although the cancer treatment went well, April developed a number of mental illnesses including major depression, a generalized anxiety...

Your insurance company has asked your treating physician to complete a questionnaire regarding your ability to work and current medical condition, what should you do? Requesting that updated questionnaires be completed by a claimant’s treating physicians seems to be standard in the review process. Usually, these forms consist of yes or no questions, check boxes and requests for comments on restrictions and limitations. If you know the insurance company has requested such questionnaires from your physicians it is beneficial for you to make an appointment with your physician to discuss...

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